Hong Finds Disparities in Clinical Trial Participation in America


Clinical trial participation in America remains low and improving equity in clinical trials is essential to reducing health disparities

image of Alicia Hong

Public participation in clinical trials are the foundation of clinical research and the cornerstone for the discovery of new treatments. Even though most Americans view clinical trials favorably, the rate of participation remains low and significant gaps exist. For example, minorities and people of low socioeconomic status are less likely to participate in clinical trials. In addition, over the past two decades the internet has reshaped how people seek health information, but it is unknown if clinical trial participation has changed with the rise of the eHealth movement, which has led people to use more telehealth and online health communications.

Data from a national representative survey, led by Dr. Alicia Hong, professor of Health Administration and Policy at George Mason University, suggest that American participation in clinical trials remains low and a significant disparity exists. People who have used eHealth tools are more likely to participate in clinical trials, and doctors who practice patient-centered communication can facilitate such participation.

The study is one of the first to report American participation in clinical trials using a large survey. Hong found that about 5% of American adults have ever participated in a clinical trial. Participation is associated with being female, white, and having a higher level of education. Data showed that health disparities in clinical trial participation remain persistent.

“Those who are more engaged in eHealth, for example, searching health information online, communicating with doctors via patient portals, using apps, or wearable devices to track health, are more likely to participate in clinical trials,” Hong said.

“We also found that if people feel their doctors or health care providers practice patient-centered communication, or when patients and providers have trusting relationships, the effect of eHealth engagement in clinical trial participation is amplified.”

“Given that significant disparities exist in American participation in clinical trials,” Hong commented, “We advocate for more targeted interventions in underserved communities. In the current context of eHealth movement, it’s critical to address the digital divide, and to enhance patient-provider communication.”

The study was partially supported by Alzheimer's and Related Diseases Research Award Fund of Virginia Center for Aging.

Clinical trial participation in America: The roles of eHealth engagement and patient–provider communication - Shaohai Jiang, Y. Alicia Hong, 2021 (sagepub.com)